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Complete response of skull base inverted papilloma to chemotherapy: Case report.
BackgroundInverted papilloma (IP) is the most common benign sinonasal neoplasm. Endoscopic techniques, improved understanding of pathophysiology, and novel surgical approaches have allowed rhinologists to treat IPs more effectively, with surgery being the mainstay of therapy. Frontal sinus IP poses a challenge for surgical therapy due to complex anatomy and potentially difficult surgical access.ObjectivesWe reported a unique case of a massive frontal sinus IP that presented with intracranial and orbital extension, with near resolution after chemotherapy.MethodsA retrospective case review of a patient with a frontal sinus IP treated at a tertiary academic medical center.ResultsA 75-year-old male patient presented with nasal obstruction, purulent nasal discharge, and a growing left supraorbital mass. Endoscopy demonstrated a mass that filled both frontal and ethmoid sinuses, with orbital invasion. There also was substantial erosion of the posterior table, which measured 1.73 Ă— 1.40 cm. A biopsy specimen demonstrated IP with carcinoma in situ. The patient was deemed unresectable on initial evaluation and, subsequently, underwent chemotherapy (carboplatin and paclitaxel). The tumor had a dramatic response to chemotherapy, and the patient elected for definitive surgery to remove any residual disease. During surgery, only a small focus of IP was found along the superior wall of the frontal sinus. No tumor was found elsewhere, including at the site of skull base erosion. The final pathology was IP without carcinoma in situ or dysplasia.ConclusionThis was the first reported case of chemotherapeutic "debulking" of IP, which facilitated surgical resection, despite substantial intracranial and orbital involvement. Although nearly all IPs can be treated surgically, rare cases, such as unresectable tumors, may benefit from systemic chemotherapy
The Cosmology Large Angular Scale Surveyor
The Cosmology Large Angular Scale Surveyor (CLASS) is a four telescope array
designed to characterize relic primordial gravitational waves from inflation
and the optical depth to reionization through a measurement of the polarized
cosmic microwave background (CMB) on the largest angular scales. The
frequencies of the four CLASS telescopes, one at 38 GHz, two at 93 GHz, and one
dichroic system at 145/217 GHz, are chosen to avoid spectral regions of high
atmospheric emission and span the minimum of the polarized Galactic
foregrounds: synchrotron emission at lower frequencies and dust emission at
higher frequencies. Low-noise transition edge sensor detectors and a rapid
front-end polarization modulator provide a unique combination of high
sensitivity, stability, and control of systematics. The CLASS site, at 5200 m
in the Chilean Atacama desert, allows for daily mapping of up to 70\% of the
sky and enables the characterization of CMB polarization at the largest angular
scales. Using this combination of a broad frequency range, large sky coverage,
control over systematics, and high sensitivity, CLASS will observe the
reionization and recombination peaks of the CMB E- and B-mode power spectra.
CLASS will make a cosmic variance limited measurement of the optical depth to
reionization and will measure or place upper limits on the tensor-to-scalar
ratio, , down to a level of 0.01 (95\% C.L.)
Early Prediction of Response to Tyrosine Kinase Inhibitors by Quantification of EGFR Mutations in Plasma of NSCLC Patients.
IntroductionThe potential to accurately quantify epidermal growth factor receptor (EGFR) mutations in plasma from non–small-cell lung cancer patients would enable more rapid and more frequent analyses to assess disease status; however, the utility of such analyses for clinical purposes has only recently started to explore.MethodsPlasma samples were obtained from 69 patients with EGFR-mutated tumors and 21 negative control cases. EGFR mutations in plasma were analyzed by a standardized allele-specific polymerase chain reaction (PCR) test and ultra-deep next-generation sequencing (NGS). A semiquantitative index (SQI) was derived from dilutions of known EGFR mutation copy numbers. Clinical responses were evaluated by Response Evaluation Criteria in Solid Tumors 1.1 criteria and expressed as percent tumor shrinkage.ResultsThe sensitivity and specificity of the PCR test and NGS assay in plasma versus tissue were 72% versus 100% and 74% versus 100%, respectively. Quantitative indices by the PCR test and NGS were significantly correlated (p < 0.001). EGFR testing at baseline and serially at 4 to 60 days during tyrosine kinase inhibitor therapy revealed a progressive decrease in SQI, starting from day 4, in 95% of cases. The rate of SQI decrease correlated with percent tumor shrinkage at 2 months (p < 0.0001); at 14 days, it was more than 50% in 70% of patients (rapid responders). In two patients with slow response, an early increase in the circulating levels of the T790M mutation was observed. No early T790M mutations were seen in plasma samples of rapid responders.ConclusionsQuantification of EGFR mutations from plasma with a standardized PCR test is feasible. To our knowledge, this is the first study showing a strong correlation between the EGFR SQI in the first days of treatment and clinical response with relevant implications for patient management
Mutational analysis of head and neck squamous cell carcinoma stratified by smoking status.
Smoking has historically been recognized as a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). This study aimed to assess the mutational differences between heavy smokers (\u3e20 pack years) and never smokers among the HNSCC patients within The Cancer Genome Atlas (TCGA). Single nucleotide variation and copy number aberration differences between heavy smokers and never smokers were compared within human papillomavirus-positive (HPV-positive) (n = 67) and HPV-negative (n = 431) TCGA cohorts with HNSCC, and the impact of these mutations on survival were assessed. No genes were differentially mutated between smoking and never-smoking patients with HPV-positive tumors. By contrast, in HPV-negative tumors, NSD1 and COL1A11 were found to be more frequently mutated in heavy smokers, while CASP8 was more frequently altered in never smokers. HPV-negative patients with NSD1 mutations experienced significantly improved overall survival compared with NSD1 WT patients. This improved prognosis was validated in an independent cohort of 77 oral cavity cancer patients and a meta-analysis that included 2 additional data sets (688 total patients, hazard ratio for death 0.44, 95% CI, 0.30-0.65). NSD1 mutations are more common in HPV-negative heavy smokers, define a cohort with favorable prognosis, and may represent a clinically useful biomarker to guide treatment deintensification for HPV-negative patients
Decoherence of quantum registers
The dynamical evolution of a quantum register of arbitrary length coupled to
an environment of arbitrary coherence length is predicted within a relevant
model of decoherence. The results are reported for quantum bits (qubits)
coupling individually to different environments (`independent decoherence') and
qubits interacting collectively with the same reservoir (`collective
decoherence'). In both cases, explicit decoherence functions are derived for
any number of qubits. The decay of the coherences of the register is shown to
strongly depend on the input states: we show that this sensitivity is a
characteristic of types of coupling (collective and independent) and not
only of the collective coupling, as has been reported previously. A non-trivial
behaviour ("recoherence") is found in the decay of the off-diagonal elements of
the reduced density matrix in the specific situation of independent
decoherence. Our results lead to the identification of decoherence-free states
in the collective decoherence limit. These states belong to subspaces of the
system's Hilbert space that do not get entangled with the environment, making
them ideal elements for the engineering of ``noiseless'' quantum codes. We also
discuss the relations between decoherence of the quantum register and
computational complexity based on the new dynamical results obtained for the
register density matrix.Comment: Typos corrected. Discussion and references added. 1 figure + 3 tables
added. This updated version contains 13 (double column) pages + 8 figures.
PRA in pres
Search for supersymmetry with a dominant R-parity violating LQDbar couplings in e+e- collisions at centre-of-mass energies of 130GeV to 172 GeV
A search for pair-production of supersymmetric particles under the assumption
that R-parity is violated via a dominant LQDbar coupling has been performed
using the data collected by ALEPH at centre-of-mass energies of 130-172 GeV.
The observed candidate events in the data are in agreement with the Standard
Model expectation. This result is translated into lower limits on the masses of
charginos, neutralinos, sleptons, sneutrinos and squarks. For instance, for
m_0=500 GeV/c^2 and tan(beta)=sqrt(2) charginos with masses smaller than 81
GeV/c^2 and neutralinos with masses smaller than 29 GeV/c^2 are excluded at the
95% confidence level for any generation structure of the LQDbar coupling.Comment: 32 pages, 30 figure
The genome of the green anole lizard and a comparative analysis with birds and mammals
The evolution of the amniotic egg was one of the great evolutionary innovations in the history of life, freeing vertebrates from an obligatory connection to water and thus permitting the conquest of terrestrial environments1. Among amniotes, genome sequences are available for mammals2 and birds3–5, but not for non-avian reptiles. Here we report the genome sequence of the North American green anole lizard, Anolis carolinensis. We find that A. carolinensis microchromosomes are highly syntenic with chicken microchromosomes, yet do not exhibit the high GC and low repeat content that are characteristic of avian microchromosomes3. Also, A. carolinensis mobile elements are very young and diverse – more so than in any other sequenced amniote genome. This lizard genome’s GC content is also unusual in its homogeneity, unlike the regionally variable GC content found in mammals and birds6. We describe and assign sequence to the previously unknown A. carolinensis X chromosome. Comparative gene analysis shows that amniote egg proteins have evolved significantly more rapidly than other proteins. An anole phylogeny resolves basal branches to illuminate the history of their repeated adaptive radiations
A population of gamma-ray emitting globular clusters seen with the Fermi Large Area Telescope
Globular clusters with their large populations of millisecond pulsars (MSPs)
are believed to be potential emitters of high-energy gamma-ray emission. Our
goal is to constrain the millisecond pulsar populations in globular clusters
from analysis of gamma-ray observations. We use 546 days of continuous
sky-survey observations obtained with the Large Area Telescope aboard the Fermi
Gamma-ray Space Telescope to study the gamma-ray emission towards 13 globular
clusters. Steady point-like high-energy gamma-ray emission has been
significantly detected towards 8 globular clusters. Five of them (47 Tucanae,
Omega Cen, NGC 6388, Terzan 5, and M 28) show hard spectral power indices and clear evidence for an exponential cut-off in the range
1.0-2.6 GeV, which is the characteristic signature of magnetospheric emission
from MSPs. Three of them (M 62, NGC 6440 and NGC 6652) also show hard spectral
indices , however the presence of an exponential cut-off
can not be unambiguously established. Three of them (Omega Cen, NGC 6388, NGC
6652) have no known radio or X-ray MSPs yet still exhibit MSP spectral
properties. From the observed gamma-ray luminosities, we estimate the total
number of MSPs that is expected to be present in these globular clusters. We
show that our estimates of the MSP population correlate with the stellar
encounter rate and we estimate 2600-4700 MSPs in Galactic globular clusters,
commensurate with previous estimates. The observation of high-energy gamma-ray
emission from a globular cluster thus provides a reliable independent method to
assess their millisecond pulsar populations that can be used to make
constraints on the original neutron star X-ray binary population, essential for
understanding the importance of binary systems in slowing the inevitable core
collapse of globular clusters.Comment: Accepted for publication in A&A. Corresponding authors: J.
Kn\"odlseder, N. Webb, B. Pancraz
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